HomeMy WebLinkAboutHomestead_Johnson (12) irt. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
? State Fonts 5473(R1515-14) HC10
Prescribed by the Oepartmera of Local Govemmem Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Semidry,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
I(We) I . t� .t. ,!, e' certify that I(we)occupied as my(our)principal
place of r'ide l+et am(are •uying the fo lowing d-/ bed r=/property under contract for which a Homestead Property Tax Standard
Deduction is hereby dawned•n the date this application is signed, (date of signature). I(We):
❑ Own. ❑ Mn(are)buying under recorded contract
o Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust _
❑ Am (are)the shareholder, partner,or member of the entity that owns the property.
___ _
- ^,-.:
If buybg on contact Fee Sinp(e ownefs name
Recorder's ofce where centred a recorded - Record number Page
- u. _ -.= _+PROPERTY:DESCRIenC'ny` _, g-
CnaEy TomsNp Taring dsrecly,town,tow^ ")
All
Pr
Parcel number Legal desaipim Its to 6t quest.=
90 w r�/0LCe.2/ 1 . Reel property ❑Annual),assessed mobile home(IC 6-1.1-7)
U any portion of the resbxal structure cc the land not exceeding cthe(1)ace that ir..-edately strromeh that s7ucure is used to(duce income,des—ibe the use and parioi
of the prwrrty reined to produce Scone.
a ‘' — /l — o / — / 00 — Do `s. 4, 6, / - oa, -7
-t -O
PROPERTYWNED ELSEWHERE BY CLAIMANT -
Sax,Couay,and Toenshrp Is claimant vacating a homestead?
❑ Yes ❑ No
Sig b re of
I hereby certify the above statements are true,correct and complete /`,
Address of content(number end street city,Safe end ZIP mho) Address of vacated any(number end street oft state,and ZIP code)
I a43 w �57� r nectar,. i✓ 7 / a
ASSESSOR USE ONLY I( ASSESSED VALUEr - I ?HOMESTEAD VALUE; :-.1 ''NON-RESIDENT(AL'-
VALUE'
Land not exceeding one(1)acts immediately -
surrounding
suounding residential improvements 10)
>-s
-sue:; -T•=-__r-:
Other land (2) _— .__. _._._ .
Total land(line 1 plus line 2) (3) _ __ _ _ _
Residential Improvements or Dwelling I(4)
Annually Assessed Mobile l
Manufactured Home Garage (5) .. '-_;: -_`` y
Other improvements (6)
Total improvements(line 4 through line 6) 1(7)
Total value (line 3 plea line 7) I(8)
Signature of Fc^a.nr Data signed(ma*day,yea)
I hereby certify the above ts true,corretL
and complete.
Verifying action-Signature of Aud-toe Date signed(month,day,year)
e� ;-VMEll° _ _ ,.?ryi_STANDARODEDUCTION'AL`LOWANCEW __ran (24 Ezs .- MI:
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 - - 'S.
Notwithstanding any otherprov6io.the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
that is not assessed as coal property of to a manufactured home that is not assessed as real properly may FEB 2 2 2011
not exceed one-half(12)of the assessed value of the mobile home or manufactured home.
Signature otNrior Dabs signed(month,day,yea)
DISTRISUTION:Orgiel-Cmmy• . ..,1=ie-sanpedcoPy_Tas»yer GIBSON COUNTY AUDITOR